The share of working-age U.S. adults without health insurance rose from 8.9 percent in 2024 to 11.2 percent in 2026, according to findings from the latest Commonwealth Fund Biennial Health Insurance Survey. The statistically significant increase coincides with the expiration of enhanced Affordable Care Act (ACA) marketplace premium tax credits at the end of 2025 and the end of pandemic-era protections that kept people enrolled in Medicaid. It also comes ahead of major Medicaid cuts and new restrictions on ACA marketplace coverage scheduled for 2027.
Based on a survey fielded from May through July 2026, the report, The State of Health Insurance Coverage in 2026, examines changes in coverage and access to care for working-age adults (ages 19–64) over the past four years.